Center for Appalachian Research in Environmental Sciences: Pilot Project: Assessing the Impact of Tobacco Product Use on Subjectively and Objectively Measured Sleep Patterns in Young Adults in the Marietta CARES Longitudinal Cohort

Project title: Assessing the Impact of Tobacco Product Use on Subjectively and Objectively Measured Sleep Patterns in Young Adults in the Marietta CARES Longitudinal Cohort. A Proposal for Pilot Funding. Abstract (Internal Use only) Although there has been a decline in the prevalence of smoking among US adults, falling from 21% to 14% from 2005-2019, rates declined faster in urban areas compared with rural areas, such as in Central Appalachia, even after controlling for numerous psychosocial and demographic risk factors for smoking. According to the Behavioral Risk Factor Surveillance System, nearly 95% of the top 50 counties that reported at least a 45% age-adjusted prevalence of short sleep were in Appalachian states. Existing literature indicates a significant relationship between tobacco smoke exposure and poor sleep outcomes in children and adolescents. Studies have shown that nicotine and other components of tobacco smoke can disrupt the natural sleep architecture, leading to short sleep duration, poor sleep quality, and excessive daytime sleepiness. Moreover, insights into sleep disruption mechanisms could lead to novel therapeutic approaches for sleep-related disorders, particularly in vulnerable Appalachian populations with high tobacco smoke exposure. To our knowledge, this is the first study to collect longitudinal, objective data to examine the relationship between objective measures of SHS (e.g. serum cotinine) during childhood and direct tobacco use during young adulthood on sleep patterns among adolescents and young adults in a rural Appalachian community. Therefore, we seek to obtain subjective measures of sleep behaviors, tobacco use, sociodemographic characteristics, and lifestyle behaviors via a one-time self-administered questionnaire at the start of the study and daily abbreviated questionnaires in Marietta CARES young adults, comparing data from self-reported tobacco users (including smokeless, heated, and electronic nicotine delivery systems or electronic cigarettes [e-cigarettes]) and non-tobacco users. We also seek to obtain serum cotinine samples and objective measures of sleep behaviors in this cohort using research- grade Fitbits (Inspire 3), comparing self-reported non-tobacco and tobacco users.